Dupuytren’s contracture occurs when knots or thick cords of tissue form just under the skin of the palm. The thickened tissue can eventually pull one or more fingers into a permanently bent position. This can make certain everyday activities difficult, such as opening the hand fully in order to grasp large objects or to put on gloves. The condition most often affects the ring and pinky fingers and normally affects one hand more than the other.
Dupuytren’s contractures typically develop over a number of years. The individual may first notice a thickening of the skin on the palm that develops into knots that may appear puckered or dimpled. The knots may be sensitive to the touch but are generally painless.
Causes and Risk Factors
The exact cause of Dupuytren’s contracture is unclear. It does not appear that vibrations, repetitive motions, or hand injuries have any bearing on the condition. Dupuytren’s contractures are most common in males over the age of 50. Individuals of Northern European descent or who have a family history of Dupuytren’s contractures are also at higher risk for the condition. Smoking, diabetes, and excessive alcohol intake are also associated with a higher risk of Dupuytren’s contracture.
Treatment for Dupuytren’s contracture
If the contractures interfere with daily activities or cause pain or neuropathy in the hand, a Los Angeles hand surgeon can use a variety of procedures to remove or separate the cords causing the contracture.
- A needle may be inserted through the skin to break apart the cords. This technique is minimally invasive and does not require extensive physical therapy or downtime; however, it cannot be used in certain locations on the finger because of the possibility of nerve injury.
- The U.S. Food and Drug Administration has approved an enzyme injection for the treatment of Dupuytren’s contractures that softens the cords so that they can be manipulated and broken apart.
- In severe cases, surgery may be required to remove the affected tissue. This normally entails a longer recovery time and extensive physical therapy. Contact LA Hand Surgeon and meet with one of our board-certified plastic hand surgeons if surgery is necessary for your condition.